Editing Breast reconstruction (section)

==Outcomes==
The typical outcome of breast reconstruction surgery is a breast mound with a pleasing aesthetic shape, with a texture similar to a natural breast, but which feels completely or mostly numb for the woman herself.<ref name=":0" />  This loss of sensation, called ''somatosensory loss'' or the inability to perceive touch, heat, cold, and pain, sometimes results in women burning themselves or injuring themselves without noticing, or not noticing that their clothing has shifted to expose their breasts.<ref name=":0" />  "I can't even feel it when my kids hug me," said one mother, who had nipple-sparing breast reconstruction after a bilateral mastectomy.<ref name=":0" />  The loss of sensation has long-term medical consequences, because it makes the affected women unable to feel itchy rashes, infected sores, cuts, bruises, or situations that risk sunburns or frostbite on the affected areas.

More than half of women treated for breast cancer develop upper quarter dysfunction, including limits on how well they can move, pain in the breast, shoulder or arm, [[lymphedema]], loss of sensation, and impaired strength.<ref name=":1">{{cite journal | vauthors = McNeely ML, Binkley JM, Pusic AL, Campbell KL, Gabram S, Soballe PW | title = A prospective model of care for breast cancer rehabilitation: postoperative and postreconstructive issues | journal = Cancer | volume = 118 | issue = 8 Suppl | pages = 2226–2236 | date = April 2012 | pmid = 22488697 | doi = 10.1002/cncr.27468 | s2cid = 205665309 | doi-access = free }}</ref>  The risk of dysfunction is higher among women who have breast reconstruction surgery.<ref name=":1" /> One in three have complications, one in five need further surgery and the procedure fails in 5%.<ref>{{Cite news|url=https://www.nytimes.com/2018/06/20/well/one-in-three-women-undergoing-breast-reconstruction-have-complications.html|title=One in Three Women Undergoing Breast Reconstruction Have Complications|work=The New York Times |date=20 June 2018 |access-date=2018-06-21| vauthors = Rabin RC }}</ref>

Some methods have specific side effects.  The [[Free flap breast reconstruction#TRAM flap — Transverse Rectus Abdominis Myocutaneous free flap|transverse rectus abdominis myocutaneous]] (TRAM) flap method results in weakness and loss of flexibility in the abdominal wall.<ref>{{cite journal | vauthors = Atisha D, Alderman AK | title = A systematic review of abdominal wall function following abdominal flaps for postmastectomy breast reconstruction | journal = Annals of Plastic Surgery | volume = 63 | issue = 2 | pages = 222–230 | date = August 2009 | pmid = 19593108 | doi = 10.1097/SAP.0b013e31818c4a9e | s2cid = 9007020 }}</ref>  Reconstruction with implants have a higher risk of long-term pain.<ref name=":1" />

Outcomes-based research on quality of life improvements and psychosocial benefits associated with breast reconstruction <ref>{{cite journal | vauthors = Harcourt DM, Rumsey NJ, Ambler NR, Cawthorn SJ, Reid CD, Maddox PR, Kenealy JM, Rainsbury RM, Umpleby HC | display-authors = 6 | title = The psychological effect of mastectomy with or without breast reconstruction: a prospective, multicenter study | journal = Plastic and Reconstructive Surgery | volume = 111 | issue = 3 | pages = 1060–1068 | date = March 2003 | pmid = 12621175 | doi = 10.1097/01.PRS.0000046249.33122.76 | s2cid = 1445626 }}</ref><ref>{{cite journal | vauthors = Brandberg Y, Malm M, Blomqvist L | title = A prospective and randomized study, "SVEA," comparing effects of three methods for delayed breast reconstruction on quality of life, patient-defined problem areas of life, and cosmetic result | journal = Plastic and Reconstructive Surgery | volume = 105 | issue = 1 | pages = 66–74; discussion 75–6 | date = January 2000 | pmid = 10626972 | doi = 10.1097/00006534-200001000-00011 | s2cid = 6651881 }}</ref> served as the stimulus in the United States for the 1998 [[Women's Health and Cancer Rights Act]], which mandated that health care payer cover breast and nipple reconstruction, contralateral procedures to achieve symmetry, and treatment for the sequelae of mastectomy.<ref>{{cite web |url=http://www.dol.gov/ebsa/publications/whcra.html |archive-url=https://web.archive.org/web/20090116025044/https://www.dol.gov/ebsa/publications/whcra.html |archive-date=2009-01-16 |date=January 15, 2009 |title=Your Rights After A Mastectomy... Women's Health & Cancer Rights Act of 1998 |publisher=U.S. Department of Labor }}</ref> This was followed in 2001 by additional legislation imposing penalties on noncompliant insurers. Similar provisions for coverage exist in most countries worldwide through national health care programs.